For some reason, I thought a potential side-effect of flu vaccines was Guillain-Barre syndrome. I mean, its super super rare, but I thought that was a stock-standard potential adverse event. Apparently, thats not the case– whether Guillain-Barre syndrome is an actual side-effect of influenza vaccines is a controversial subject (not just with anti-vaxers, or hoaxers, but like, the real world). It might have just been a freak accident in one years batch of vaccines in the 1970s, it might have been a statistical fluke, it might not be anything.

But the field itself is concerned about adverse effects of vaccines, so instead of threateningresearchers, they investigated whether there was a connection between Guillain-Barre syndrome and the swine flu vaccine (hehehe, remember swine flu? good times…).

In a source population of around 50 million people in Europe we could not find any association between adjuvanted pandemic influenza A (H1N1) 2009 vaccine and Guillain-Barré syndrome (adjusted odds ratio 1.0, 95% confidence interval 0.3 to 2.7).

In retrospect, the swine flu vaccine was safe. Yay!

Certainly thats comforting, but whats also comforting is that researchers looked. They looked at the data, and if something was amiss, we would have a reason to investigate what was causing the problem, thus figure out how we can fix the problem. You dont know unless you look, we looked. I was speaking to an old friend recently, and he asked whether this sort of thing happened, or whether researchers just say “Meh, it got FDA approval” and dropped it. Its comforting to know that isnt the case– Its not just about safety during initial clinical trials, researchers keep an eye on these kinds of things once drugs and vaccines are on the market, too.

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except maybe possibly contributing to an increase in narcolepsy (huh? how does that even work?) in young people in some European countries… but again, something that researchers are trying to figure out.

From my reading of the history I’m pretty sure that the start of the US anti-vax movement comes from or at least relates to the 70s flu vaccine and Guillain-Barre syndrome. The vaccine for the flu was being produced as quickly as possible and government ordered vaccination(not sure if that mean mandatorily taking the vaccine or mandatorily distributing it) was underway when the CDC showed up at Ford’s doorstep and told him that they were calling off the emergency … what looked like a pandemic was not. But since it was a congressional mandate and congress was either slow or not in session it went ahead. This added libertarians an cynics of government to the list of people who did not like vaccines and is one of the political reasons that the US Congress has been reluctant to require influenza vaccines (say for kids in schoo, etc.).

(This may be a bit off … it is based on my memory of Laurie Garret’s book)

I mean, thank you and those in your field for, you know, seeing a potential problem and then collecting and analyzing data to see what it shows.

For the record, even knowing there are legitimate risks with certain vaccinations, weighing that against the risk of not taking them, I take them. Except for anthrax. I declined that particular vaccine (even during the whole – zomg, like 3 people have been by terrorist anthrax!!!!one!!!! help! hoopla of 2001.)

Do you suppose that those who’ve been decrying this particular vaccine will accept the data, or just keep on keepin’ on?

Offit’s book put the start of the modern anti-vax in the USA largely as a consequence of the “documentary” DPT: Vaccine Roulette (yes, it’s DPT, not DTP). My own reading suggests old origins for anti-vaccine (anti-immunisation, too) protesting, essentially going back to when vaccination (immunisation) first started. My own thinking at the moment is that individuals who promote the anti-vax deal each have their own starting or “trigger” points, that differ for each person, so the various anti-vax organisations have their own starting point. Offit ties Barabara Loe and her lot to the DPT “documentary”, for example.

This is definitely good news, both that it didn’t cause GBS and that they did followup. I did get the vaccine, but the possibility was absolutely in the back of my mind. My great-grandfather was one of the ~50 people who had confirmed GBS from the vaccine in the 70s. This happened just before I was born, but I remember growing up hearing all about him getting sick and dying. Thankfully, his death didn’t seem to turn anyone in my family anti-vax or anti-medicine.

Swine flu vaccination was not mandatory, or at least not for most people, back during the Ford administration (1976). I know, I was there. I did get the shot, since it was being recommended at the time. And I didn’t get GBS (no big surprise), but some people sure did, and I don’t think there was much doubt that the shot did it.

I’m very glad to know that the 2009 version doesn’t cause GBS. I’d be even happier if we knew what’s changed since 1976. Do we?

Got the vaccine, got the GBS got the trach scar for a souvenir. My dad (an MD and epidemiologist) figured it for a bad batch of vaccine and we continue to trust science. ( I must thank those of you who get the flu vaccine, since various doctors in my life have recommended I not get it.)

And to answer the question above, narcolepsy — which I have, so I know rather a lot about it — is most likely autoimmune. Current thinking is that a specific little set of neurons that produce hypocretin/orexin are targeted. Unfortunately, though it’s a small number of cells dying off, they’re hugely important ones when it comes to regulation of sleep, appetite, muscle tone, all sorts of miscellany. The integration of those various signals gets all FUBAR.

I could see how trying to ramp an immune response with some particular vax could trigger those of us lucky enough to have the predisposition into the full on disease. It would probably be most visible in youth, since it’s more common for the symptoms to become really clear a bit later on.

If you actually read the papers, it doesn’t show that the H1N1 vaccines cannot be a trigger for GBS, but simply that it is a rare event. On the other hand, it is arguable for those susceptible to GBS, it could be triggered if they were infected with H1N1 in the first place.

It is possible that the reduction in incidence over the years could be due to improved vaccine quality.

I am mostly pro-vax, at least up to the herd immunity threshold (my specific views depend on the specific vaccine and current risk of contracting the virus in question).
I just wish we knew more about how such reactions can occur, so we can either screen out for the possibility, or treat it.

I myself suffered a serious averse reaction to a vaccination when I was 15 years old, that has caused permanent disability (so far, since there are no good treatments). I learned the hard way that rare does not mean non-existent.

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